Staged Acclimatization in a Failing Fontan by AFR in AFR: Ever-Decreasing Circles
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Updated: Oct 7, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Jenny E Zablah1, Natalie Soszyn1, Gareth J Morgan1
1Division of Cardiology, Department of Pediatrics, Heart Institute, Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA.
Abstract:
We describe serial implantation of atrial flow regulator (AFR) devices in the Fontan fenestration of a 4-year-old patient. Initially, the fenestration size was decreased using a 6/5 AFR, resulting in improved saturations and hemodynamics. One year later, further improvement was achieved by placing a 4/10 AFR inside the original device. (Level of Difficulty: Advanced.).
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